MEDICARE: MIRTHA LOUIGEUNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	5174504	FL

General Provider Information

NPI Number	:	1265000178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRTHA LOUIGEUNE

Provider Business Mailing Address
First Line	:	5880 W SAMPLE RD APT 301
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3247
Country	:	US
Telephone Number	:	941-237-6455
Fax Number	:

Provider Business Practice Location Address
First Line	:	5880 W SAMPLE RD APT 301
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3247
Country	:	US
Telephone Number	:	941-237-6455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	06/16/2021

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Directions to “ MIRTHA LOUIGEUNE ” Practice Location

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